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Level 27

Antimicrobials (drug side effects)


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allergy (1-10% have some allergy, 0.05% have anaphylaxis)
Penicillins
encephalopathy
Penicillins (very high dose or severe renal failure)
diarrhoea, maculopapular rash
Penicillins
hypernatraemia, hyperkalaemia
IV penicillins
cholestatic hepatitis
Co-amoxiclav
allergy (crossover with penicillin allergy)
Cephalosporins
GI intolerance, diarrhoea, phlebitis (IV)
Macrolides
cholestatic hepatitis, generalised rash, prolongued QTc, high LFTs
Macrolides (rare)
increased effect of theophylline, warfarin
Macrolides interactions
increased risk of myositis with statins
Macrolides interactions
GI intolerance, diarrhoea, stained teeth
Tetracyclines
hepatitis, dysphagia, candidiasis
Tetracyclines (rare)
nausea, diarrhoea, headache, malaise, insomnia
Fluoroquinolones
tendon rupture, photosensitivity, prolongued QTc, peripheral neuropathy
Fluoroquinolones (rare)
interstitial nephritis, hepatic failure, severe allergic reactions
Fluoroquinolones (rare)
dose-related ototoxicity, nephrotoxicity
Aminoglycosides
should not be given with potentially ototoxic diuretics (e.g. furosemide)
Aminoglycosides interactions
GI intolerance, metallic taste, headache, dark urine
Metronidazole
peripheral neuropathy, phlebitis (IV), reaction with alcohol
Metronidazole (rare)
diarrhoea, GI intolerance, nausea, vomiting, anorexia
Clindamycin
measles-like rash, c dif colitis
Clindamycin (rare)
nausea, diarrhoea, headaches
Trimethoprim
hyperkalaemia, decreased clotting, severe skin reaction
Trimethoprim (rare)
GI intolerance
Nitrofurantoin
hypersensitivity with acute pulmonary symptoms
Nitrofurantoin (rare)
interstitial pulmonary fibrosis
Nitrofurantoin (chronic)
'red man syndrome' (flushing +/- hypotension, pruritus)
Vancomycin
phlebitis, impaired renal function, back spasms
Vancomycin
neutropaenia, thrombocytopaenia, fever, tissue irritation, ototoxicity
Vancomycin (rare)
peripheral neuropathy
Isoniazid
hepatitis, psychosis, SLE-like syndrome
Isoniazid (rare)
disturbed liver function, decreased effectiveness of hormonal contraceptives
Rifampicin
influenza-like, abdominal, respiratory symptoms; shock, renal failure, thrombocytopaenic purpura
Rifampicin (rare)
liver toxicity
Pyrazinamide (rare)
visual disturbance (loss of acuity, colour blindness, restriction of visual fields)
Ethambutol